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Listeria monocytogenes Infection In a Prosthetic Knee Joint In Rheumatoid Arthritis During Methotrexate Therapy
J Wollenhaupt1, T Busche, H Zeidler
1Division of Rheumatology, Department of Internal Medicine (J.W., H.Z.), and Division of Orthopedic Surgery (T.B.), Hannover Medical School, Hannover, Germany.
Abstract:
A 70-year-old man with rheumatoid arthritis developed Listeria monocytogenes septic arthritis in his prosthetic right knee. He initially responded well to ampicillin, but later developed relapse of Listeria joint infection. The prosthesis was removed, and arthrodesis was performed. This report suggests that prolonged antimicrobial treatment is necessary to cure this rare cause of septic arthritis of prosthetic joints in immunocompromised patients.
Insights
This case report highlights a rare Listeria monocytogenes septic arthritis in a prosthetic knee. Prolonged antibiotic therapy is crucial for immunocompromised patients to prevent relapse of this serious joint infection.
Area of Science:
- Infectious Diseases
- Rheumatology
- Orthopedic Surgery
Background:
- Rheumatoid arthritis patients are susceptible to opportunistic infections.
- Prosthetic joint infections pose significant treatment challenges.
- Listeria monocytogenes is an uncommon but serious pathogen in septic arthritis.
Purpose of the Study:
- To report a case of recurrent Listeria monocytogenes septic arthritis in a prosthetic knee.
- To emphasize the importance of prolonged antimicrobial therapy in immunocompromised individuals.
- To discuss management strategies for rare prosthetic joint infections.
Main Methods:
- Case presentation of a 70-year-old male with rheumatoid arthritis and prosthetic knee.
- Initial treatment with ampicillin for Listeria monocytogenes infection.
- Management of recurrent infection involving prosthesis removal and arthrodesis.
Main Results:
- The patient experienced a relapse of Listeria joint infection despite initial antibiotic response.
- Surgical intervention (prosthesis removal and arthrodesis) was required for definitive management.
- Recurrence underscores the challenges in treating Listeria prosthetic joint infections.
Conclusions:
- Listeria monocytogenes septic arthritis of prosthetic joints is rare, particularly in immunocompromised patients.
- Successful treatment necessitates prolonged antimicrobial courses.
- A multidisciplinary approach involving infectious disease and orthopedic specialists is vital.
